COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK
COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK
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DOI：
10.1136/sextrans-2020-054768
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发表时间：
2021-11-01
影响因子：
3.6
通讯作者：
Girometti, Nicolo
中科院分区：
文献类型：
--
作者：
Hyndman, Iain;Nugent, Diarmuid;Girometti, Nicolo
目的新冠肺炎大流行及其相关限制措施已经影响了英国性保健服务的使用和提供。我们调查了男男性行为(MSM)对性行为的影响，以便为未来的SHS规定提供信息。方法对在迪安街56号性健康与HIV诊所就诊的HIV阴性、HIV感染高危人群进行横断面匿名网络调查。这项调查是在2020年8月进行的，为期7天。摘录了封锁期间(定义为2020年3月23日至6月30日)的社会人口学特征、性行为和相关精神健康状况的数据。分类变量和非分类变量根据HIV暴露前预防(PrEP)的使用情况进行比较。结果814名男男性接触者完成问卷调查，75%的男男性接触者为PrEP使用者，76%的男男性接触者有过性行为，其中76%的男男性接触者在家外发生性行为。75%的受访者报告称，与封锁前相比，合作伙伴数量减少。孤独/孤独(48%)和焦虑/压力(27%)会引发性行为，73%的人曾与性伴侣讨论过新冠肺炎的传播风险。46%的人报告称，性行为后的情绪没有改变，20%的人表示因违反新冠肺炎限制而感到内疚。76%的人对自己的性行为进行了一个或多个改变，而58%的人采取了一个或多个步骤来减少性行为期间新冠肺炎的传播。36%的人获得了SHS，30%的人报告在获得检测/治疗方面遇到了困难。在那些访问过SHS的人中，28%的人报告了STI诊断。与非PrEP使用者相比，Prep使用者报告的伴侣数量、参与“化学性行为”和使用SHS的比例更高。结论新冠肺炎限购对被调查者的性行为和心理健康有相当大的影响。据报道，在封锁期间，性行为和性传播感染的诊断率很高。为男男性行为者提供的SHS服务的变化必须应对心理和性传播感染相关的高发病率以及这一人群在获得服务方面所面临的挑战。
Objectives The COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services (SHS). We surveyed the impact on sexual behaviour of men having sex with men (MSM) to inform future SHS provision. Methods We conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended 56 Dean Street, a sexual health and HIV clinic. The survey was conducted over a 7-day period in August 2020. Data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown (defined as 23 March-30 June 2020) were extracted. Categorical and non-categorical variables were compared according to HIV pre-exposure prophylaxis (PrEP) use. Results 814 MSM completed the questionnaire: 75% were PrEP users; 76% reported they have been sexually active, of which 76% reported sex outside their household. 75% reported fewer partners than prior to lockdown. Isolation/loneliness (48%) and anxiety/stress (27%) triggered sexual activity, and 73% had discussed COVID-19 transmission risks with their sexual partners. While 46% reported no change to emotions ordinarily experienced following sex, 20% reported guilt for breaching COVID-19 restrictions. 76% implemented one or more changes to their sexual behaviour, while 58% applied one or more steps to reduce COVID-19 transmission during sex. 36% accessed SHS and 30% reported difficulties in accessing testing/treatment. Of those who accessed SHS, 28% reported an STI diagnosis. PrEP users reported higher partner number, engagement in 'chemsex' and use of SHS than non-PrEP users. Conclusions COVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in our survey respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to SHS provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.